AVERA MCKENNAN: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- AVERA MCKENNAN (EIN 46-0224743)
- Tax period
- 2024-07-01 to 2025-06-30
- Filed
- 2026-05-15
- IRS object ID
- 202621359349301797
- Schema version
- 2024v5.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-05-15T09:25:54-05:00 | ReturnTs |
| Tax Period End | 2025-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 460224743 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Avera McKennan | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AVER | BusinessNameControlTxt |
| Phone | 6053228000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1325 South Cliff Ave | AddressLine1Txt |
| City | Sioux Falls | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571175045 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Julie Lautt | PersonNm |
| Person Title | CFO - Avera Health | PersonTitleTxt |
| Phone | 6053228000 | PhoneNum |
| Signature | 2026-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2026-04-29 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Dr Ronald Place | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1325 South Cliff Ave | AddressLine1Txt |
| City | Sioux Falls | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 571175045 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,038,887,393 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | avera.org/locations/mckennan/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1911 | FormationYr |
| Legal Domicile State | SD | LegalDomicileStateCd |
| Activity Or Mission | Promotion of health | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 10231 | TotalEmployeeCnt |
| Total Volunteers | 1472 | TotalVolunteersCnt |
| Total Gross UBI | $14,788,278 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $4,723,653 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $23,424,006 | PYContributionsGrantsAmt |
| CY Contributions Grants | $22,096,038 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,555,760,564 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,659,194,241 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,766,915 | PYInvestmentIncomeAmt |
| CY Investment Income | $26,099,927 | CYInvestmentIncomeAmt |
| PY Other Revenue | $127,499,062 | PYOtherRevenueAmt |
| CY Other Revenue | $152,126,195 | CYOtherRevenueAmt |
| PY Total Revenue | $1,712,450,547 | PYTotalRevenueAmt |
| CY Total Revenue | $1,859,516,401 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,285,250 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $780,094 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $796,205,485 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $866,828,584 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $348,502 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $781,640,493 | PYOtherExpensesAmt |
| CY Other Expenses | $901,860,620 | CYOtherExpensesAmt |
| PY Total Expenses | $1,579,131,228 | PYTotalExpensesAmt |
| CY Total Expenses | $1,769,469,298 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $133,319,319 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $90,047,103 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,820,643,330 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,085,749,648 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $814,768,536 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $939,926,119 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,005,874,794 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,145,823,529 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Avera is a health ministry rooted in the Gospel. Our mission is to make a positive impact in the lives and health of persons and communities by providing quality services and guided by Christian values. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,625,838,053 | ExpenseAmt |
| Grant | $780,094 | GrantAmt |
| Revenue | $1,799,243,165 | RevenueAmt |
| Desc | Avera McKennan's mission is to provide healthcare services to Sioux Falls, South Dakota residents and residents of the surrounding area. Avera McKennan is a 501(c)(3) organization affiliated with Avera Health. Avera McKennan consists of a 641-bed hospital, a 53-bed heart hospital and a 126-bed nursing home in Sioux Falls, SD. Major service lines include oncology, surgery, obstetrics, pediatrics, neonatology, emergency and trauma, critical care including EICU, radiology and diagnostic imaging, psychiatry, behavioral health, pulmonary, orthopedics, neurology, cardiology, and gastroenterology. Transplant services include solid organ (kidney and pancreas) and bone marrow transplant.Avera McKennan owns or leases rural critical hospitals and a nursing home in South Dakota including a 13-bed critical access hospital and a 30-bed nursing home in Gregory, SD, a 25-bed critical access hospital in Milbank, SD, a 23-bed critical access hospital in Dell Rapids, SD, an 18-bed critical access hospital in Flandreau, SD, an 11-bed critical access hospital in Miller, SD (Hand County), and an 11-bed critical access hospital in Rock Rapids, IA. Services offered by the rural critical access hospitals include radiology and imaging, colonoscopy and endoscopy, therapy and rehabilitation, 24-hour emergency care, chemotherapy, orthopedics, cardiovascular testing, surgery, dialysis, and obstetrics.In addition, Avera McKennan provides clinical care, secondary and primary, through physician clinics in South Dakota, Northwest Iowa, Southwest Minnesota, and Northeastern Nebraska. The physician clinics provide primary care and urgent care, and specialties such as cardiology, dermatology, endocrinology, gastroenterology, hematology, hepatology, infectious disease, internal medicine, neonatology, nephrology, neurology, ob/gyn, oncology, ophthalmology, pediatrics, orthopedics, rheumatology, pain management, psychiatry, pulmonology, general surgery, and vascular services. Following is a breakdown of these statistics by facility:Avera McKennan Hospital 26,881 Acute patient discharges 1,976 Newborn patient discharges 496,817 Outpatient visits 3,757 Newborn patient days 981,919 Clinic visitsAvera Heart Hospital 3,059 Acute patient discharges 34,830 Outpatient visits 87,097 Clinic visitsAvera Prince of Peace 43,307 Long-term care resident days 361 Long-term care patient dischargesAvera Gregory Hospital (CAH) 207 Acute patient discharges 88 Swing-bed patient discharges 11,859 Outpatient visits 648 Swing-bed patient days 14,995 Clinic visitsAvera Rosebud Country Care Center 10,346 Long-term care resident days 23 Long-term care patient dischargesAvera Milbank Hospital (CAH) 258 Acute patient discharges 36 Newborn patient discharges 57 Swing-bed patient discharges 18,183 Outpatient visits 54 Newborn patient days 409 Swing-bed patient days 20,656 Clinic visitsAvera Dell Rapids Hospital (CAH) 143 Acute patient discharges 67 Swing-bed patient discharges 10,984 Outpatient visits 702 Swing-bed patient days 14,388 Clinic visitsAvera Flandreau Hospital (CAH) 109 Acute patient discharges 6 Swing-bed patient discharges 8,663 Outpatient visits 54 Swing-bed patient days 7,809 Clinic visitsAvera Hand County Hospital (CAH) 131 Acute patient discharges 39 Swing-bed patient discharges 10,599 Outpatient visits 376 Swing-bed patient days 8,266 Clinic visitsAvera Merrill Pioneer Hospital (CAH) 70 Acute patient discharges 37 Swing-bed patient discharges 9,130 Outpatient visits 409 Swing-bed patient days 5,693 Clinic visitsAvera McKennan maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy and equivalent service statistics. The amount of charges foregone, based on established rates, were $66,380,580.Avera McKennan also provides community benefit health activities at less than or at no cost to support those in the area serviced, see Schedule H. As a member of the Avera Health Network, Avera McKennan upholds the vision of the Presentation and Benedictine Sisters to work through collaboration to provide quality, effective health ministry, and to improve the healthcare of individuals and our communities through a regionally integrated network of persons and institutions. Avera McKennan engages in activities designed to improve the health of individuals and communities in response to a calling to heal the sick, the elderly, and the oppressed. | Desc |
| Total Program Service Expenses | $1,625,838,053 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 637 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 10231 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | 0 | WrittenPolicyOrProcedureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jamie Schaefer | PersonNm |
| Phone | 6053223992 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3900 W Avera Dr Ste 300 | AddressLine1Txt |
| City | Sioux Falls | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57108 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Geoffrey Haft MD | ||||||||||
| Orthopedics/Surgery | 40.00 | 0.00 | Yes (X) | $1,788,145 | $0 | $59,664 | ||||
| Todd Zimprich MD | ||||||||||
| Neurology | 40.00 | 0.00 | Yes (X) | $1,688,192 | $0 | $54,908 | ||||
| Jonathan Gilhooly MD | ||||||||||
| Neurosurgery | 40.00 | 0.00 | Yes (X) | $1,668,772 | $0 | $55,457 | ||||
| Alex Linn MD | ||||||||||
| Neurology | 40.00 | 0.00 | Yes (X) | $1,534,309 | $0 | $52,408 | ||||
| Richard J Conklin MD | ||||||||||
| Oncology | 40.00 | 0.00 | Yes (X) | $1,510,044 | $0 | $60,434 | ||||
| David Flicek | ||||||||||
| Former President & CEO | 0.00 | 0.00 | $0 | $1,450,140 | $47,062 | Yes (X) | ||||
| Julie Lautt CFO Avera | ||||||||||
| Health;Secretary/Treasurer | 0.10 | 46.30 | $0 | $1,274,363 | $20,218 | Yes (X) | ||||
| Ronald Place MD | ||||||||||
| President & CEO | 42.00 | 0.00 | $0 | $1,093,970 | $28,917 | Yes (X) | Yes (X) | |||
| Cristina Hill Jensen MD | ||||||||||
| Board Member/Gastroenterology | 42.00 | 0.00 | $971,709 | $0 | $58,294 | Yes (X) | ||||
| Benjamin Solomon MD | ||||||||||
| Board Member/Oncology & Hematology | 42.00 | 0.00 | $787,357 | $0 | $62,864 | Yes (X) | ||||
| Jawad Nazir MD Board Member | ||||||||||
| Infectious Disease & Internal Med | 42.00 | 0.00 | $638,805 | $0 | $63,864 | Yes (X) | ||||
| Brenda Kallemeyn MD Board Member | ||||||||||
| /Chief of Staff/ OB & Gyn | 42.00 | 0.00 | $466,151 | $0 | $33,436 | Yes (X) | ||||
| Tamera Larsen Engelkes | ||||||||||
| Chief Nursing Officer | 40.00 | 0.00 | $328,460 | $0 | $18,804 | Yes (X) | ||||
| Alisa Reindl MD | ||||||||||
| Board Member/Family Med, OB | 2.00 | 0.00 | $230,353 | $0 | $25,358 | Yes (X) | ||||
| J Pat Costello | ||||||||||
| Chair | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |||
| Jennifer Bunkers | ||||||||||
| Vice Chair | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |||
| Sister Candyce Chrystal | ||||||||||
| Board Member | 2.00 | 6.00 | $0 | $0 | $0 | Yes (X) | ||||
| Sister Mary Carole Curran | ||||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Van Fishback | ||||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Jeff Gordon Board Member | ||||||||||
| Philanthropy Council Chair | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Jennifer Kirby | ||||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Randy Knecht | ||||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Laurie Knutson | ||||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Sanaa Abourezk | ||||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Ryan Boschee | ||||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Sister Roxanne Seifert | ||||||||||
| Board Member | 2.00 | 5.00 | $0 | $0 | $0 | Yes (X) | ||||
| Sister Lucille Welbig | ||||||||||
| Board Member | 2.00 | 10.00 | $0 | $0 | $0 | Yes (X) | ||||
| Harriet Yocum | ||||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $11,612,297 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,818,473 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $641,688 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1446 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Avera Health | |||||
| 3900 West Avera Drive | Sioux Falls | SD | 57108 | Shared Services | $147,597,708 |
| Journey Group Companies | |||||
| 4500 W 58th St | Sioux Falls | SD | 57108 | Construction Services | $25,758,162 |
| AMN Healthcare Inc | |||||
| 12400 High Bluff Dr | San Diego | CA | 92130 | Contract Labor | $13,242,425 |
| BWBR Architects | |||||
| 380 St Peter St Ste 600 | St Paul | MN | 55102 | Architect services | $8,122,480 |
| Surgical Institute of South Dakota PC | |||||
| 911 E 20th St 700 | Sioux Falls | SD | 57105 | Medical Dir & Prof Fees | $5,911,434 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 92 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $48,347 | FederatedCampaignsAmt |
| Related Organizations | $5,455,575 | RelatedOrganizationsAmt |
| Government Grants | $13,356,045 | GovernmentGrantsAmt |
| All Other Contributions | $3,236,071 | AllOtherContributionsAmt |
| Total Contributions | $22,096,038 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient Service Revenue | 621110 | $1,489,569,698 | $1,486,331,301 | $3,238,397 |
| Pharmacy Revenue | 456110 | $99,798,962 | $99,798,962 | |
| Patient and Clinic Revenue | 621500 | $12,204,957 | $11,839,975 | $364,982 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,620,624 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $57,620,624 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,659,194,241 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,488,530 | TotalRevenueColumnAmt |
| Exclusion | $1,488,530 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,488,278 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,199,285 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$2,711,007 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,711,007 | TotalRevenueColumnAmt |
| Exclusion | -$2,711,007 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $28,186,012 | SecuritiesAmt |
| Other | $142,162 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $3,716,777 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $28,186,012 | SecuritiesAmt |
| Other | -$3,574,615 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,611,397 | TotalRevenueColumnAmt |
| Exclusion | $24,611,397 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $313,783,678 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $169,454,930 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $144,328,748 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $140,029,896 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $4,298,852 | UnrelatedBusinessRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Commercial Testing | 541380 | $4,271,259 | $4,271,259 | |
| A/R Interest Income | 900099 | $3,254,226 | $3,254,226 | |
| Sports Programs | 611600 | $2,982,969 | $2,614,788 | $368,181 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,508,454 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,859,516,401 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,799,243,165 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $14,788,278 | UnrelatedBusinessRevenueAmt |
| Exclusion | $23,388,920 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,911 | TotalAmt |
| Program Services | $178,911 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $601,183 | TotalAmt |
| Program Services | $601,183 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,797,677 | TotalAmt |
| Program Services | $3,797,677 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,714 | TotalAmt |
| Program Services | $92,714 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $714,654,800 | TotalAmt |
| Program Services | $702,671,614 | ProgramServicesAmt |
| Management And General | $11,983,186 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,340,799 | TotalAmt |
| Program Services | $27,855,965 | ProgramServicesAmt |
| Management And General | $484,834 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,670,381 | TotalAmt |
| Program Services | $71,933,750 | ProgramServicesAmt |
| Management And General | $1,736,631 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,272,213 | TotalAmt |
| Program Services | $45,457,317 | ProgramServicesAmt |
| Management And General | $814,896 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,590 | TotalAmt |
| Program Services | $42,590 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $342,254 | TotalAmt |
| Program Services | $94,547 | ProgramServicesAmt |
| Management And General | $247,707 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,907 | TotalAmt |
| Management And General | $38,907 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,071,345 | TotalAmt |
| Program Services | $213,408,871 | ProgramServicesAmt |
| Management And General | $107,606,236 | ManagementAndGeneralAmt |
| Fundraising | $56,238 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,071,021 | TotalAmt |
| Program Services | $802,742 | ProgramServicesAmt |
| Management And General | $79,334 | ManagementAndGeneralAmt |
| Fundraising | $188,945 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,277,449 | TotalAmt |
| Program Services | $13,198,429 | ProgramServicesAmt |
| Management And General | $2,059,208 | ManagementAndGeneralAmt |
| Fundraising | $19,812 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,548,152 | TotalAmt |
| Program Services | $8,386,540 | ProgramServicesAmt |
| Management And General | $161,612 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,757,015 | TotalAmt |
| Program Services | $17,446,353 | ProgramServicesAmt |
| Management And General | $7,310,662 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,053,401 | TotalAmt |
| Program Services | $4,902,527 | ProgramServicesAmt |
| Management And General | $150,874 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,681,935 | TotalAmt |
| Program Services | $3,603,889 | ProgramServicesAmt |
| Management And General | $78,046 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,815,486 | TotalAmt |
| Program Services | $20,589,773 | ProgramServicesAmt |
| Management And General | $2,225,713 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,181,183 | TotalAmt |
| Program Services | $53,853,455 | ProgramServicesAmt |
| Management And General | $4,327,728 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,829,964 | TotalAmt |
| Program Services | $1,253,879 | ProgramServicesAmt |
| Management And General | $1,576,085 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $415,841,254 | $414,555,643 | $1,261,173 | $24,438 |
| Equipment Lease/Rental | $4,962,950 | $4,535,856 | $373,352 | $53,742 |
| Provision for Income Ta | $1,663,276 | $1,663,276 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,682,438 | TotalAmt |
| Program Services | $14,910,552 | ProgramServicesAmt |
| Management And General | $766,559 | ManagementAndGeneralAmt |
| Fundraising | $5,327 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,769,469,298 | TotalAmt |
| Program Services | $1,625,838,053 | ProgramServicesAmt |
| Management And General | $143,282,743 | ManagementAndGeneralAmt |
| Fundraising | $348,502 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$1,022,710 | BOYAmt |
| EOY | $602,470 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,273,949 | BOYAmt |
| EOY | $247,708,037 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,142,751 | BOYAmt |
| EOY | $49,341,688 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,792,250 | BOYAmt |
| EOY | $12,399,613 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,334,901,843 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $680,766,607 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $584,620,857 | BOYAmt |
| EOY | $654,135,236 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,463,668 | BOYAmt |
| EOY | $70,471,295 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $609,254,394 | BOYAmt |
| EOY | $802,696,114 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,424,488 | BOYAmt |
| EOY | $21,631,829 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,922,144 | BOYAmt |
| EOY | $35,811,212 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,771,539 | BOYAmt |
| EOY | $190,952,154 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,820,643,330 | BOYAmt |
| EOY | $2,085,749,648 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,290,765 | BOYAmt |
| EOY | $125,310,207 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $771,666 | BOYAmt |
| EOY | $833,163 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $562,830,938 | BOYAmt |
| EOY | $558,163,090 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,120 | BOYAmt |
| EOY | $17,684 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,280,933 | BOYAmt |
| EOY | $123,282,517 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,577,114 | BOYAmt |
| EOY | $132,319,458 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $814,768,536 | BOYAmt |
| EOY | $939,926,119 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $978,656,050 | BOYAmt |
| EOY | $1,111,973,244 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,218,744 | BOYAmt |
| EOY | $33,850,285 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,005,874,794 | BOYAmt |
| EOY | $1,145,823,529 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,820,643,330 | BOYAmt |
| EOY | $2,085,749,648 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $90,047,103 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $37,725,330 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $12,176,302 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $38,907 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $38,907 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Avera McKennan participates through various hospital organizations to promote legislation that would result in strengthening health care delivery systems on a national, regional, and local level. Dues were paid to the following organizations and a portion is attributable to lobbying. $23,718 South Dakota Association of Healthcare Organizations 4,347 Sioux Falls Chamber of Commerce 785 Iowa Hospital Association 6,502 South Dakota State Medical Association (SDSMA) 3,555 340b Healthcare | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,192,787 | BeginningYearBalanceAmt |
| Contributions | $253,164 | ContributionsAmt |
| Investment Earnings Or Losses | $998,689 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $287,824 | OtherExpendituresAmt |
| Administrative Expenses | $7,655 | AdministrativeExpensesAmt |
| End Year Balance | $10,149,161 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,248,494 | BeginningYearBalanceAmt |
| Contributions | $397,618 | ContributionsAmt |
| Investment Earnings Or Losses | $793,335 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $246,660 | OtherExpendituresAmt |
| End Year Balance | $9,192,787 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,562,405 | BeginningYearBalanceAmt |
| Contributions | $409,240 | ContributionsAmt |
| Investment Earnings Or Losses | $540,911 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $264,062 | OtherExpendituresAmt |
| End Year Balance | $8,248,494 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,837,855 | BeginningYearBalanceAmt |
| Contributions | $904,132 | ContributionsAmt |
| Investment Earnings Or Losses | -$975,298 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $204,284 | OtherExpendituresAmt |
| End Year Balance | $7,562,405 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,708,176 | BeginningYearBalanceAmt |
| Contributions | $189,307 | ContributionsAmt |
| Investment Earnings Or Losses | $1,182,839 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $242,467 | OtherExpendituresAmt |
| End Year Balance | $7,837,855 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.05587 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.74094 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.20319 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $28,907,683 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $33,280,079 | OtherCostOrOtherBasisAmt |
| Book Value | $62,187,762 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $4,459,982 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $745,026,458 | OtherCostOrOtherBasisAmt |
| Depreciation | $356,497,322 | DepreciationAmt |
| Book Value | $392,989,118 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,078,492 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,257,845 | DepreciationAmt |
| Book Value | $7,820,647 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $464,907,161 | OtherCostOrOtherBasisAmt |
| Depreciation | $303,596,203 | DepreciationAmt |
| Book Value | $161,310,958 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,241,988 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,415,237 | DepreciationAmt |
| Book Value | $29,826,751 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $654,135,236 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (4 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Avera Pooled Investments | $739,138,590 | F |
| Interest in Avera Health Foundation | $37,997,428 | F |
| Investment in Heart Hospital of South Dakota, LLC | $24,712,134 | F |
| Investments in Affiliated Companies | $847,962 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $802,696,114 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other Assets | $162,705 |
| Right of Use Assets | $70,309,005 |
| Intercompany Assets | $120,362,555 |
| Security Deposits | $117,889 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $190,952,154 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| Derivative Liability | $1,598,722 |
| Estimated third-party payor settlements | $11,109,793 |
| Minority interest | $3,878,337 |
| Other Liabilities | $3,728,400 |
| Right of Use Capital Lease Obligations | $5,845,572 |
| Security Deposits | $19,673 |
| Intercompany Liabilities | $105,988,961 |
| Long Term Commitments | $150,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $132,319,458 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part IV, Line 2b: | The Organization holds funds on behalf of its residents. |
| Part V, Line 4: | The Organization's endowment consists of a portion of their interest in the net assets of Avera Health Foundation. The Avera Health Foundation includes endowment funds which have been established for a variety of purposes. As required by generally accepted accounting principles, net assets associated with endowment funds, including funds designated by the Board of Directors to function as endowments (if any), are classified and reported based on the existence or absence of donor-imposed restrictions. The Organization's permanently restricted endowment funds are donor restricted. The Organization currently does not have any board designated endowment funds. |
| Part X, Line 2: | Avera Health and its sponsored organizations believe that they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Organization would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| Most Hospitals Policy | Yes (X) | MostHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,669,798 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,669,798 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $139,279,776 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $100,156,799 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,122,977 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02210 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,646,378 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,308,374 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $338,004 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $157,595,952 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $101,465,173 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $56,130,779 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03170 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,335,960 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $991,770 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,344,190 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,699,545 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,804,512 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,895,033 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,739,375 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $31,390,150 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,349,225 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00640 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,764,098 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,610,034 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,154,064 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,169,627 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,169,627 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $78,708,605 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $46,796,466 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $31,912,139 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01800 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $236,304,557 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $148,261,639 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $88,042,918 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04970 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,645 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $12,645 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,465 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,465 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,610 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $22,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $37,004,255 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $333,453,646 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $358,327,899 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$24,874,253 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 8 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (8 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Childrens HospitalChildrensHospitalInd | Teaching HospitalTeachingHospitalInd | Research FacilityResearchFacilityInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc | Critical Access HospitalCriticalAccessHospitalInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera McKennan | ||||||||||||||
| 1 | 1325 S Cliff Ave | Sioux Falls | SD | 57117 | See Part V Section C | 10563 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 41 Provider Based Clinics | |
| Heart Hospital of South Dakota LLC | ||||||||||||||
| 2 | 4500 W 69th Street | Sioux Falls | SD | 57108 | See Part V Section C | 41953 | Yes (X) | Yes (X) | Yes (X) | 2/3 Owner in Joint Venture | ||||
| Avera Milbank Area Hospital | ||||||||||||||
| 3 | 901 Virgil Ave | Milbank | SD | 57252 | See Part V Section C | 48451 | Yes (X) | Yes (X) | Yes (X) | 2 Rural Health PB Clinics & 2 Rural Health Free-Standing Clinics | Yes (X) | |||
| Avera Gregory Healthcare Center | ||||||||||||||
| 4 | 110 S Logan Ave | Gregory | SD | 57533 | See Part V Section C | 54875 | Yes (X) | Yes (X) | Yes (X) | 1 Provider Based Clinic & 1 Rural Health PB Clinic | Yes (X) | |||
| Avera Dells Area Health Center | ||||||||||||||
| 5 | 909 N Iowa Avenue | Dell Rapids | SD | 57022 | See Part V Section C | 50754 | Yes (X) | Yes (X) | Yes (X) | 1 Provider Based Clinics | Yes (X) | |||
| Avera Flandreau Medical Center | ||||||||||||||
| 6 | 214 N Prairie | Flandreau | SD | 57028 | See Part V Section C | 10540 | Yes (X) | Yes (X) | Yes (X) | 1 Rural Health Provider Based Clinic | Yes (X) | |||
| Avera Hand County Memorial Hospital | ||||||||||||||
| 7 | 300 W 5th St | Miller | SD | 57362 | See Part V Section C | 53862 | Yes (X) | Yes (X) | Yes (X) | 1 Provider Based Clinic | Yes (X) | |||
| Avera Merrill Pioneer Hospital | ||||||||||||||
| 8 | 1100 S 10th Ave | Rock Rapids | IA | 51246 | See Part V Section C | 600118H | Yes (X) | Yes (X) | Yes (X) | 2 Rural Health Provider Based Clinics | Yes (X) | |||
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (8 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Prior CHNA ImpactPriorCHNAImpactInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy Website URLStrategyWebsiteURLTxt | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Asset Level CriteriaAssetLevelCriteriaInd | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Other CriteriaOtherCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Available On WebsiteFAPAvailableOnWebsiteInd | FAP Available On Website URLFAPAvailableOnWebsiteURLTxt | FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd | FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt | FAP Summary On WebsiteFAPSummaryOnWebsiteInd | FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd | FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd | Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd | Communtity Notified FAPCommuntityNotifiedFAPInd | FAP TranslatedFAPTranslatedInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | Provided Written NoticeProvidedWrittenNoticeInd | Made Effort Orally NotifyMadeEffortOrallyNotifyInd | Processed FAP ApplicationProcessedFAPApplicationInd | Made Presumptive Elig DetermMadePresumptiveEligDetermInd | Other Actions TakenOtherActionsTakenInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Look Back Medicare PrivateLookBackMedicarePrivateInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera McKennan | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 24 | Yes (1) | Yes (1) | Yes (1) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | Yes (1) | 24 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Heart Hospital of South Dakota LLC | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 24 | Yes (1) | Yes (1) | Yes (1) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | Yes (1) | 24 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera Gregory Healthcare Center | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 4 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 24 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | Yes (1) | 24 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera Milbank Area Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 3 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 24 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | Yes (1) | 24 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera Dells Area Health Center | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 5 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 24 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | Yes (1) | 24 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera Flandreau Medical Center | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 6 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 24 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | Yes (1) | 24 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera Hand County Memorial Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 7 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 24 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | Yes (1) | 24 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| Avera Merrill Pioneer Hospital | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 8 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 24 | Yes (1) | 0 | 0 | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | Yes (1) | 24 | Yes (1) | See Part V, Section C | 0 | Yes (1) | Yes (X) | 250.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | See Part V, Section C | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
Supplemental Information SupplementalInformationGrp (28 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Avera McKennan | Part V, Section B, Line 5: Avera McKennan solicited community input in a variety of methods. A survey of residents in the Sioux Falls Metropolitan Statistical area was conducted. Three focus groups were conducted. Key informant individual interviews were conducted. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources, and improvements. Those providing community input represented the medically underserved, low-income and minority populations as they serve these populations through their activities. |
| Heart Hospital of South Dakota, LLC | Part V, Section B, Line 5: Heart Hospital of South Dakota, LLC solicited community input in a variety of methods. A survey of residents in the Sioux Falls Metropolitan Statistical area was conducted. Three focus groups were conducted. Key informant individual interviews were conducted. The process involved determining the participant's opinions on our community's strengths, weaknesses, resources, and improvements. Those providing community input represented the medically underserved, low-income, and minority populations as they serve these populations through their activities. |
| Avera Gregory Healthcare Center | Part V, Section B, Line 5: The Community Health Needs Assessment was completed in 2025. We used an outside consultant to bring together multiple community members and organizations to answer the question: "What health needs can our facility be a partner in addressing?" Our organization used primary evidence gathering techniques with one-on-one interviews, online surveys, and town hall events. We also met with local organizations including the Lion's club, Rotary club, city council, county commissioners, the local EMS providers, the volunteer fire department, and various church organizations that represented at risk community members. The Avera Gregory Hospital Advisory Board approved the Community Health Needs Assessment. |
| Avera Milbank Area Hospital | Part V, Section B, Line 5: The assessment process, initiated by Milbank Area Hospital Avera, is an effort to identify the strengths and weaknesses of services offered at Milbank Area Hospital Avera. Community input was solicited through surveys and personal interviews with community members with special knowledge of the needs of the community. Throughout the data collection process, steps were taken to ensure the hospital's community health needs assessment took into account input from persons who represent the broad interests of the community, including the medically underserved, minority, senior citizens, children, and low-income populations. |
| Avera Dells Area Health Center | Part V, Section B, Line 5: Community input was solicited using a variety of methods. To gather a broad range of interests and ensure accurate community input and representation, Facebook Surveys were solicited, surveys were placed in our various lobbies, and individual personalized invitations went out to various groups and individuals. Special attention/invitations were focused on medically underserved, low income, and minority population groups. The community surveys and other solicitation of data occurred over two months, February - March, 2025. |
| Avera Flandreau Medical Center | Part V, Section B, Line 5: Community input was solicited using a variety of methods. To gather a broad range of interests and ensure accurate community input and representation, Facebook Surveys were solicited, surveys were placed in our various lobbies, and individual personalized invitations went out to various groups and individuals, including our auxiliary who also took surveys to their various social groups. Special attention/invitations were focused on medically underserved, low income, and minority population groups. The community surveys and other solicitation of data occurred over multiple months, beginning in October 2024. |
| Avera Hand County Memorial Hospital | Part V, Section B, Line 5: The CHNA process began by defining the community and collecting secondary data and resources. Once that was completed, the process continued with primary data collection including online and paper surveys. Special attention/invitations were focused on medically underserved, low income, and minority population groups. The internal CHNA committee reviewed the data collected and identified the community health needs to improve overall health of the community. The needs were then prioritized. The Avera Hand County Memorial Hospital Board of Directors approved the Community Health Needs Assessment. |
| Avera Merrill Pioneer Hospital | Part V, Section B, Line 5: Avera Merrill Pioneer Hospital conducted a community survey to collect information and data across a broad demographic of the community. The survey was distributed using Facebook and paper copies at Avera Medical Group Clinics in Rock Rapids, George, and Larchwood. The survey overall goal was reaching a wide demographic representative of the overall county population. Key informant interviews were conducted to get a closer look at problem areas identified from a previous community health needs assessment and to connect with individuals serving vulnerable or medically underserved populations. The key informant interviews were conducted over the phone with Lyon County Public Health, Sioux Rivers Regional Disability Services Coordinator, Lyon County Ambulance Director, Rock Rapids Health Center Director of Nursing, the Central Lyon High School Superintendent, and West Lyon High School Superintendent. Throughout the data collection process, steps were taken to ensure the hospital's community health needs assessment considered input from persons who represent the broad interests of the community, including the medically underserved, minority, senior citizens, children, and low-income populations. |
| Avera McKennan | Part V, Section B, Line 6a: The CHNA was conducted with Heart Hospital of South Dakota, LLC, Sioux Falls VA Medical Center, and Sanford USD Medical Center. |
| Heart Hospital of South Dakota, LLC | Part V, Section B, Line 6a: The CHNA was conducted with Avera McKennan, Sioux Falls VA Medical Center, and Sanford USD Medical Center. |
| Avera McKennan | Part V, Section B, Line 6b: City of Sioux Falls Health Department |
| Heart Hospital of South Dakota, LLC | Part V, Section B, Line 6b: City of Sioux Falls Health Department |
| Avera McKennan | Part V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2025. The community health priority areas identified were: Healthy Living, Adolescent Mental Health, and Access to Care. The identified needs will be addressed through a three-year, Community Health Improvement Plan (CHIP). Avera McKennan and the Avera Heart Hospital will participate in efforts to support strategies to improve Healthy Living, Adolescent Mental Health, and Access to Care.Avera McKennan and Avera Heart Hospital are addressing, or collaborating to address, all aspects of all top needs identified in the 2025 Community Health Needs Assessment.Avera McKennan and Avera Heart Hospital maintained its Community Health Improvement Plan to address the needs identified and prioritized in the FY2022 Community health needs assessment. In FY2025 Avera McKennan began incorporating steps to address the needs identified in the FY2025 Community Health Assessment along with the needs identified in the prior Community Health Needs Assessment.PRIORITY AREAS: ACTIVE LIVING/HEALTHY EATING/HEALTHYLIVINGImproving healthy living involves addressing social determinants of health, including food insecurity, which continues to be a need identified in the CHNA. The Avera Wellness Pantries began operation in the fall of 2024 and has expanded to multiple Sioux Falls and other locations with future plans for growth. Patients who need it have access to emergency bags of food with healthy, shelf-stable items at no cost to them, thanks to the partnership between the Avera Research Institute, Avera's Community Partnerships Program and Feeding South Dakota. Over 1,000 bags of food have been provided to patients with food insecurity. Avera Research Institute launched Avera Healthy Start, a public health program that aims to improve maternal and infant outcomes across South Dakota, including in Sioux Falls. The program, which began in 2024, provides resources and standardized education to pregnant patients and families with young children to encourage healthy behavior. Through this program, participants have the opportunity to work with a social worker and dietician, as well as attend one-on-one and group educational classes. Both rural and immigrant/refugee communities are focus areas for Healthy Start. Healthy living includes fall prevention, which was specifically mentioned in the 2025 CHNA as an area of concern. Avera McKennan Hospital began holding daily safety huddles with inpatient care teams in February of 2025. The huddles are intended to be quick, focused meetings for staff to share critical safety concerns and help staff to make informed decisions to protect patients. Since starting the daily safety huddles, there has been an 83% reduction in falls with fractures. PRIORITY AREA: MENTAL HEALTH AND SUBSTANCE USE/ADOLESCENT MENTAL HEALTHAdolescent mental health is a topic that is being addressed in multiple ways. Inpatient needs, for example, are addressed at the Helmsley Behavioral Health Center, a wing of the Avera Behavioral Health Hospital, providing residential and partial hospitalization for youth addiction rehabilitation. This includes 8 adolescent beds for residential treatment for 45 days. Schools are an important piece of adolescent mental health. The Sioux Falls Area Community Foundation (SFACF) received a large donation to support adolescent mental health in schools. The SFACF worked with the Sioux Falls School District to choose Avera as their behavioral health partner. This three-year trial will add 5 new counselors, who will begin seeing students in early 2026. To increase access to all mental healthcare, future staffing needs to be considered. The Health Resources and Services Administration (HRSA) recently awarded Avera Behavioral Health a $2.4 million grant to fund Avera BRIGHT: Building Rural Innovation and Growth in Behavioral Health Teams in South Dakota. Over four years, a partnership between Avera Behavioral Health and the University of South Dakota plans to train and retain 12 culturally competent graduate students per year.PRIORITY AREA: ORAL HEALTH/PREVENTATIVE CARE/ACCESS TO CAREAvera continued its efforts to improve childhood oral health through participation in various community events. Avera continued to invest in the community and develop resources for the community. Avera continues to utilize The Resource Center as a trusted space where community members can go for assistance in establishing primary care, specialty care, screenings, jobs, insurance enrollment, and other important quality-of-life services. In 2025, Avera began sending text messages to patients who may be eligible for Medicaid or financial assistance, improving affordability.Increasing access to care requires evaluation and expansion of services offered by Avera. A six-story tower at the Avera McKennan campus, currently under construction, will expand women's and children's comprehensive care space. Completion is expected in early 2027. To meet current and future patient demand, Avera will also begin offering all-day acute care services at the Family Health Center on Marion Road. |
| Heart Hospital of South Dakota, LLC | Part V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2025. The community health priority areas identified were: Healthy Living, Adolescent Mental Health, and Access to Care. The identified needs will be addressed through a three-year, Community Health Improvement Plan (CHIP). Avera Heart Hospital and Avera McKennan will participate in efforts to support strategies to improve Healthy Living, Adolescent Mental Health, and Access to Care.Avera Heart Hospital and Avera McKennan are addressing, or collaborating to address, all aspects of all top needs identified in the 2025 Community Health Needs Assessment.Avera Heart Hospital and Avera McKennan maintained its Community Health Improvement Plan to address the needs identified and prioritized in the FY2022 Community health needs assessment. In FY2025 Avera Heart Hospital and Avera McKennan began incorporating steps to address the needs identified in the FY2025 Community Health Assessment along with the needs identified in the prior Community Health Needs Assessment.PRIORITY AREAS: ACTIVE LIVING/HEALTHY EATING/HEALTHYLIVINGImproving healthy living involves addressing social determinants of health, including food insecurity, which continues to be a need identified in the CHNA. The Avera Wellness Pantries began operation in the fall of 2024 and has expanded to multiple Sioux Falls and other locations with future plans for growth. Patients who need it have access to emergency bags of food with healthy, shelf-stable items at no cost to them, thanks to the partnership between the Avera Research Institute, Avera's Community Partnerships Program and Feeding South Dakota. Over 1,000 bags of food have been provided to patients with food insecurity. Avera Research Institute launched Avera Healthy Start, a public health program that aims to improve maternal and infant outcomes across South Dakota, including in Sioux Falls. The program, which began in 2024, provides resources and standardized education to pregnant patients and families with young children to encourage healthy behavior. Through this program, participants have the opportunity to work with a social worker and dietician, as well as attend one-on-one and group educational classes. Both rural and immigrant/refugee communities are focus areas for Healthy Start. Healthy living includes fall prevention, which was specifically mentioned in the 2025 CHNA as an area of concern. Avera began holding daily safety huddles with inpatient care teams in February of 2025. The huddles are intended to be quick, focused meetings for staff to share critical safety concerns and help staff to make informed decisions to protect patients. Since starting the daily safety huddles, there has been an 83% reduction in falls with fractures. PRIORITY AREA: MENTAL HEALTH AND SUBSTANCE USE/ADOLESCENT MENTAL HEALTHAdolescent mental health is a topic that is being addressed in multiple ways. Inpatient needs, for example, are addressed at the Helmsley Behavioral Health Center, a wing of the Avera Behavioral Health Hospital, providing residential and partial hospitalization for youth addiction rehabilitation. This includes 8 adolescent beds for residential treatment for 45 days. Schools are an important piece of adolescent mental health. The Sioux Falls Area Community Foundation (SFACF) received a large donation to support adolescent mental health in schools. The SFACF worked with the Sioux Falls School District to choose Avera as their behavioral health partner. This three-year trial will add 5 new counselors, who will begin seeing students in early 2026. To increase access to all mental healthcare, future staffing needs to be considered. The Health Resources and Services Administration (HRSA) recently awarded Avera Behavioral Health a $2.4 million grant to fund Avera BRIGHT: Building Rural Innovation and Growth in Behavioral Health Teams in South Dakota. Over four years, a partnership between Avera Behavioral Health and the University of South Dakota plan to train and retain 12 culturally competent graduate students per year.PRIORITY AREA: ORAL HEALTH/PREVENTATIVE CARE/ACCESS TO CAREAvera continued its efforts to improve childhood oral health through participation in various community events. Avera continued to invest in the community and develop resources for the community. Avera continues to utilize The Resource Center, as a trusted space where community members can go for assistance in establishing primary care, specialty care, screenings, jobs, insurance enrollment, and other important quality-of-life services. In 2025, Avera began sending text messages to patients who may be eligible for Medicaid or financial assistance, improving affordability.Increasing access to care requires evaluation and expansion of services offered by Avera. A six-story tower at the Avera McKennan campus, currently under construction, will expand women's and children's comprehensive care space. Completion is expected in early 2027. To meet current and future patient demand, Avera will also begin offering all-day acute care services at the Family Health Center on Marion Road. |
| Avera Gregory Healthcare Center | Part V, Section B, Line 11: The community health needs assessment was completed during fiscal year 2025. The hospital has not taken specific actions with respect to the FY2025 implementation strategy. The following community health priority areas were identified and the following actions will be taken by the hospital during future years. - Behavioral Health Coverage - Take action to ensure there are proper resources in our community to address behavioral healthcare needs, both in the emergency room and clinically - More exercise opportunities in the community - In coordination with local governments and community organizations help develop a master plan to expand exercise opportunities in our communityDuring the community health needs assessment process, the following health needs emerged but are beyond the scope, expertise, resources, or control of Avera Gregory at this time: inability to make primary care appointments, ultrasound coverage, long term care access, and increased surgical access at the facility. Avera Gregory continued to address the community health needs identified in the community health needs assessment completed in FY2022. The following community health priority areas were identified: need for new facilities in our area to administer healthcare, increase diagnostic capabilities of our imaging department to eliminate unnecessary travel, and increased need for dialysis in our community.The new Avera Gregory Hospital facility ensures the sustainability and accessibility of local healthcare. The facility, including the hospital, clinic and long-term care center, significantly enhances the community's access to comprehensive medical services in a modern, patient-centered environment. The magnetic resonance imaging (MRI) suite in the Gregory Hospital, reduces the need for patients to travel long distances for diagnostic imaging. In addition to reducing travel for patients, the imaging department upgrade enables musculoskeletal and other complex scans to be performed on-site five days a week. Patient wait times have decreased, and access to timely diagnosis has substantially improved. Avera Gregory expanded its dialysis unit's capacity on January 1, 2025. The unit now operates six days a week, doubling its patient capacity from 12 to 24 patients per week. This expansion has significantly reduced the burden of travel and wait times for individuals with chronic kidney disease in the community. |
| Avera Milbank Area Hospital | Part V, Section B, Line 11: The community health needs assessment was completed during FY2025. The hospital has not taken specific actions with respect to the FY2025 implementation strategy. The following community health priority areas were identified and the following actions will be taken by the hospital during future years. - Improve access to care by enhancing the dissemination of resource materials on available services, visiting specialists and local medical staff - Increase awareness and education on the health impact of vaping and tobacco use as a preventative health priority with a youth-focus - Promote healthy eating and nutrition education to address obesityThe Milbank Area Hospital Avera developed a three-year implementation strategy to address priority health needs identified through the 2025 Community Health Needs Assessment (CHNA). The plan focuses on the aforementioned priority areas, with goals, resources, and community partners for each area.Improvement to access to care initiatives include profiling and actively marketing local medical providers, promoting the schedules and specialties of vising specialists, and regularly updating and distributing comprehensive lists of hospital services through various channels. The initiatives aim to reduce barriers to care and ensure that community members are well-informed about the full range of medical services available.Initiatives to increase awareness of the serious health hazards of vaping and tobacco use will focus on education and collaboration. The plan includes placing informative signage across the hospital campus, working in partnership with the local school district to disseminate age-appropriate and impactful messaging, offer educational sessions within the community, and develop and distribute digital and print materials highlighting the dangers of vaping and tobacco use. The initiatives aim to encourage peer-led advocacy and provide resources with the intent to shift perceptions and reduce tobacco and vape use in the community.Initiatives to promote health eating and nutrition education include, tailoring educational sessions to specific audiences, launch a community-wide campaign featuring tips, healthy recipes, and dietitian guidance through social media and community events, and offering nutrition consultations or referrals to registered dietitian during routine medical visits. The initiatives aim to reduce obesity-related health risks and empower the community to make healthier food choices. Progress will be reviewed annually and shared in the next CHNA cycle. The implementation plan was approved in October 2025 and is publicly available on the Avera website.Milbank Area Hospital Avera will not be directly addressing other areas of concern, such as depression and mental illness, heart disease, affordability, childcare, and lack of health or dental insurance, identified through the assessment process. While the leadership team recognizes that other concerns exist, the hospital does not have the resources or expertise to address at this time.Milbank Area Hospital Avera continued to address the community health needs identified in the community health needs assessment completed in FY2022. Milbank Area Hospital Avera maintained its implementation plan for each of the priorities of mental health services, outreach to ethnic minority patients, and health education and health screening. MENTAL HEALTHMilbank Area Hospital Avera has successfully recruited a licensed mental health counselor. This effort has enhanced access to care for individuals in need of mental health support and has been successful by aiding those in need of mental health services. Milbank Area Hospital Avera continues meaningful progress toward addressing a critical gap in local behavioral health resources. The Grief Share program continues to be offered to the community. This is a 13-week facilitated program with a warm and safe environment to express emotions. Additionally, a one-day Surviving the Holidays seminar is held. Continue to educate on understanding suicide and knowing the warning signs. Utilize the Avera "Ask the Question" Campaign.MINORITY POPULATIONMilbank Area Hospital Avera continues to make progress in improving access and communication for non-English speaking patients. Milbank Area Hospital Avera has successfully recruited a fluent Spanish-speaking physician. Multilingual signage has been installed throughout the facility to assist with navigating and understanding. In addition, key patient care documents have been translated to ensure clarity and informed decision making material is available and there has been more consistent use of the language translation line to support real-time communication during medical appointments. HEALTH EDUCATION/SCREENINGSAvera Milbank Area Hospital, along with Avera Medical Group Milbank, continues to provide education for the public through their Facebook page. Avera Milbank Area Hospital has implemented two screening programs related to a heart and vascular risk reduction clinic that provides patients with key data related to their cardiac risk scores along with access to carotid artery screening, abdominal aortic aneurysm screening, and peripheral artery disease screening. To further support early detection, the screenings include calcium score CT, blood pressure, body mass index, cholesterol and blood sugar check, education, and risk assessment with an expert cardiovascular team. Additionally, a CT lung screening program specifically designed to assess lung cancer in current and former smokers is now offered. |
| Avera Dells Area Health Center | Part V, Section B, Line 11: The Community Health Needs Assessment (CHNA) was completed during fiscal year 2025. Avera Dells Area Hospital developed a three-year implementation plan to address the priority health needs identified through the 2025 CHNA. The following community health priority areas were identified and the following actions will be taken by the hospital during future years. - Access to Mental Health - Investigate opportunities to offer on-site or in-community counseling - Partner with a local organization to develop a community resources pamphlet with specific attention to mental health access - Community Resources - Update referral list of various community or larger county and service area resources - Take steps to provide readily accessible data to patients, families, and community members of all resources available locally, and if not offered locally, resources offered regionally that support our service area. - Transportation - Partner with a local organization to develop a community resources pamphlet that includes a specific section on transportation, highlighting the various types of transportation accessible to community residents and service area residents. - Coordinate with local ministerial association to provide support for access to the hospital and assistance with transporting ambulatory patients home from the hospital. - Take action to enhance patient and prospective patient ability to seek medical attention when needed, and to assist discharged ambulatory patients with transportation home when there is no family or friend to transport them. - Access to Care - Take action to increase access to care leading to better overall health outcomes. Take steps to offer earlier disease detection, more preventative care, and improved management of chronic conditions. - Recruit additional doctors and nursing support staff. Avera Dells Area Hospital does not currently have the resources to take on and prioritize all the health needs identified in the FY2025 CHNA, such as community center with a pool and a new hospital facility. Avera Dells Area Hospital maintained its implementation plan to address the needs identified and prioritized in the FY2022 Community health needs assessment. Two needs were identified in the FY2022 Community health needs assessment: - Offer additional local healthcare services - Access/convenience to medical careAvera Dells Area Hospital continued to use social media and online portals to promote local health care services available in the community. The Hospital participated in community events to promote local health services and educate the public on preventative health and wellness programs and opportunities. Avera Dells Area Hospital partnered with external partner Restorix to provide wound care services weekly in Dell Rapids. Using an Avera Dells Area nurse practitioner and nursing support from Restorix, these services are offered every Thursday to patients with wide ranging demographics including those that are under or uninsured. This has resulted in over 400 wound care encounters performed locally, saving patients from traveling for these services. This service has won several awards. Avera Dells Area Hospital will continue the commitment to patient experience and outcomes and possibly even expand depending on the volume trends. Avera Dells Area Hospital continued to expand access to several services. The need for additional access to occupational therapy services in Dell Rapids was recognized. Avera Dells Area added a part-time occupational therapist who provides services four days/week in Dell Rapids. This provides local occupational therapist services to both inpatients and outpatients in our community and reduces the need for additional transportation. |
| Avera Flandreau Medical Center | Part V, Section B, Line 11: The community health needs assessment was completed during FY2025. The hospital has not taken specific actions with respect to the FY2025 implementation strategy. The following community health priority areas were identified: - Access to healthcare through outreach services - Sustainability of Ambulance servicesDuring the community health needs assessment process, the following health needs/priorities emerged but are beyond the scope, expertise, resources, or control of Avera Flandreau at this time: elderly are, childcare, mental health, and transportation.Avera Flandreau continued to address the community health needs identified in the community health needs assessment completed in FY2022. The following community health priority areas were identified: Access to Healthcare through Affordability, and Chemical Dependency Services. Access to Healthcare through AffordabilityAvera Flandreau continues to be compliant with the Health Care Price Transparency Act and provides its pricing information to the public via its website. Avera Flandreau continues to provide out-of-pocket cost estimates for scheduled patients who will be paying for services with their own resources (not using a third-party payer). This process provides patients an estimate of what they will be responsible for after their visit. Avera is also nearing completion of a more automated process for all patients in which they will have an estimate of out-of-pocket costs they will incur for scheduled visits to Avera Flandreau Hospital and Avera Medical Group-Flandreau.Avera Flandreau continues to offer charity care to those eligible for the service and for those who complete the necessary paperwork. Opportunities may exist to create greater awareness and greater ease of use of this process.Avera Flandreau supported the Medicaid Expansion constitutional amendment. Upon its passing, eligible Moody County residents gained insurance coverage.Chemical Dependency ServicesAvera Flandreau continued to improve public awareness of health care service options for individuals dealing with mental health concerns or chemical dependency. Avera Flandreau provides space in the clinic for a community mental health counselor and routinely makes referrals to this professional.Avera Flandreau started a telemedicine behavioral health triage program in the ER. The Avera Behavioral Health Assessment Team is available to our patients 24/7; this is a free service to the public.Moody County Cares mental health board is community based and run by county residents. Avera Flandreau employees are active on the mental health board and will look for ways to partner toward meeting our goal. |
| Avera Hand County Memorial Hospital | Part V, Section B, Line 11: Avera Hand County conducted a community health needs assessment during FY2025. After review of the primary and secondary data, the Hand County leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Avera Hand County is committed to addressing the following prioritized community health needs: - Community Education - Take action to provide monthly educational materials accessible in formats to reach as diverse of population as possible. Monthly topics related to but not limited to: nutrition, mental health, chronic disease management, preventative screenings, safety, and healthy lifestyle choices. - Take action to host health and wellness fair open to the community at large. - Physician Recruitment - Partner with organizations such as the South Dakota Office of Rural Health to help connect communities such as ours with medical professionals through incentive programs, loan repayment opportunities, and rural training. - Work with community organizations and development groups in collaboration to showcase the benefits of living and working in the area, helping to attract providers by emphasizing the strong community ties, low cost of living, and quality of life.The prioritized needs encompassed the largest amount of concern, dissatisfaction, and needs identified by the respondents. No other community health needs rose to the same level of concern. Avera Hand County maintained its implementation plan to address the needs identified and prioritized in the FY2022 Community health needs assessment.Mental Health Access and ResourcesAvera Hand County continues to improve mental health access and resources in the community. Community Counseling of Huron, SD, currently manages the central South Dakota region, providing a counselor in Miller upon request as an outreach service. The hospital has also implemented coordinated care service and has implemented behavioral health via telemedicine. Health & Weight Management and MaintenanceThe hospital and clinic have utilized their Facebook platform to educate the public on challenges and information available through Avera Health's Balance blog. These challenges and helpful tips have been shared on Avera's Facebook page to help bring awareness to the community. In addition, Avera has increased awareness to our registered dietitian for referrals.The hospital and clinic participated in the local Farm and Home Show by offering complimentary blood pressure checks, immunization information, and educational handouts on health-related topics. |
| Avera Merrill Pioneer Hospital | Part V, Section B, Line 11: Avera Merrill Pioneer conducted a community health needs assessment during FY2025. After review of the primary and secondary data, the Avera Merrill Pioneer leadership team weighed the findings against available resources and potential sustainability. These criteria were used as they prioritized the identified needs.Based on the results of this assessment, Avera Merrill Pioneer is committed to addressing the following identified significant community health needs: 1. Improving the mental health of the community a. Take action to increase community mental health education, expand screening for depression and mental health, and pursue funding to purchase telehealth equipment to provide expanded mental health counseling. 2. Obesity a. Take action to educate the community on healthy eating and collaborate with the city of Rock Rapids to provide exercise opportunities. 3. Improve utilization of preventative care a. Take action to improve immunization compliance, promote preventive health care and screenings, and improve management of chronic health conditions.At this time, all of the identified Community Health Priorities are being supported in some way. We work hard to continue to advance our service to better meet the needs of our community.Avera Merrill Pioneer continued to address the community health needs identified in the community health needs assessment completed in FY2022. Avera Merrill Pioneer maintained its implementation plan for addressing the health need prioritized in the FY2022 community health needs assessment.Improve access to Mental Health services in Lyon County - Continue to utilize Flowstate in the ER to support our patients with Behavioral Health needs. This includes evaluation to determine if outpatient or inpatient care is best for next steps. If inpatient care is determined as the next step, Flowstate supports finding appropriate placement. They have strong working relationships with area Behavioral Health services to best facilitate this process in a timely manner. - We provide fliers in our public areas including clinic waiting rooms and hospital waiting rooms sharing local Behavioral Health Services in our area. - To identify patients with higher risk of depression, we continue screening in our clinics and emergency department utilizing the evidence based PHQ-9 questionnaire. - Avera Merrill Pioneer Hospital CEO is a member of the Lyon County Behavioral Health Team, which works to promote local behavioral health services within Lyon County and beyond. - Promote mental health service through different community speaking events, such as the Kiwanis club or lunch and learns.Provide services and promote a healthy lifestyle - Continue to utilize the comprehensive weight management program through the AMG clinic. This program works with patients to evaluate current situation, diet, activity, eating habits and comorbidities associated or exacerbated by excess weight. Together the patient, provider, dietitian, and other care team members as needed develop a holistic treatment plan that includes diet, exercise, non-pharmacologic, and pharmacologic options. This approach is designed to best manage weight loss for the long-term in an effective and safe manner. - We continue to promote via patient education and online resources the importance of being physically active and encourage the community to take advantage of the walking trail and fitness stations. - In collaboration with the City of Rock Rapids and the Rock Rapids Development Corporation, continue to emphasize the importance of physical activity and expansion and improvement of the community's overall walking trail system. - Avera Merrill Pioneer Hospital CEO is an active member of the Lyon County Planning Council, which works to promote healthcare services in the Lyon County area and beyond. - The Patient and Family Advisory Council is developing lunch and learn opportunities available to the public to discuss multiple different topics.Provide preventative care services to promote the health of the community. - Through our Facebook page, Avera Merrill Pioneer and Avera Medical Group promote health screenings including sports physicals, immunizations, colonoscopy, mammography and more. - The hospital is currently providing space for Lyon County Public Health whose offices were destroyed during a flood. By providing this space, they can continue their work to promote health and provide services to the community in an appropriate setting. - Promote preventative care services through different community speaking events, such as the Kiwanis club or lunch and learns. |
| Part V, Section B, line 7a: | Hospital facility's website for CHNA:avera.org/about/community-health-needs-assessments/ |
| Part V, Section B, line 10a: | Hospital facility's website for Implementation Strategy:avera.org/about/community-health-needs-assessments/ |
| Part V, Section A website addresses: | Avera McKennanavera.org/locations/profile/avera-mckennan-hospital-university-health-center/Heart Hospital of South Dakota, LLCavera.org/locations/profile/avera-heart-hospital-sioux-falls/Avera Milbank Area Hospitalavera.org/locations/profile/milbank-area-health-care-campus/Avera Gregory Healthcare Centeravera.org/locations/profile/avera-gregory-hospital/Avera Dells Area Health Centeravera.org/locations/profile/avera-dells-area-hospital/Avera Flandreau Medical Centeravera.org/locations/profile/avera-flandreau-hospital/Avera Hand County Memorial Hospitalavera.org/locations/profile/avera-hand-county-memorial-hospital/Avera Merrill Pioneer Hospitalavera.org/locations/profile/avera-merrill-pioneer-hospital/ |
| Part V, Section B, Line 13h: | Presumptive charity care may be applied in situations where all other avenues of financial assistance have been exhausted. The facility has the discretion to weigh extenuating circumstances when determining eligibility for and the amount of charity care to provide. |
| Part V, Section B, Line 16a, 16b, and 16c: | avera.org/patients-visitors/pay-my-bill-online/financial-assistance-programs/ |
| Part V, Section B, Line 16j: | A summary of the financial assistance policy is posted in the hospital facility's emergency rooms, waiting rooms, and admissions office and included on the billing statement. In addition, the financial assistance policy is discussed with the patient upon admission to the facility. |
| Part V, Section B, Line 20e: | If a patient is self-pay and has a large balance, an Avera patient advocate will help them apply for other forms of assistance. If they are not eligible for any other coverage, the patient is given a financial assistance application to complete and return to the facility. |
| Part V, Section B, Line 24: | The hospital financial assistance policy does not cover elective procedures. The hospital may have charged FAP eligible patients gross charges for services that are not covered under the financial assistance policy. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 41 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (41 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Avera McKennan Behavioral Health Center | ||||
| 4400 W 69th St | Sioux Falls | SD | 57108 | Inpatient & Outpatient behavioral health services |
| 2 - Avera Plaza 2 Pharmacy | ||||
| 1301 S Cliff Avenue Suite 225 | Sioux Falls | SD | 57105 | Retail pharmacy |
| 3 - Avera Prince of Peace | ||||
| 4500 S Prince of Peace Place | Sioux Falls | SD | 57103 | Skilled nursing facility |
| 4 - Avera McKennan Home Infusion | ||||
| 4101 W Memory Circle Suite 110 | Sioux Falls | SD | 57107 | Comprehensive home infusion therapies & supplies |
| 5 - Avera Brookings Infusion | ||||
| 310 22nd Ave STE 101 | Brookings | SD | 57006 | Comprehensive home infusion therapies & supplies |
| 6 - McKennan Regional Laboratory | ||||
| 1325 S Cliff Avenue | Sioux Falls | SD | 57105 | Laboratory services |
| 7 - Avera Medical Group Worthington | ||||
| 1216 Ryans Road | Worthington | MN | 56187 | Primary care clinic |
| 8 - Avera Rosebud Country Care Center | ||||
| 300 Park Avenue | Gregory | SD | 57533 | Skilled nursing facility |
| 9 - Avera McKennan Fitness Center | ||||
| 3400 S Southeastern Drive | Sioux Falls | SD | 57105 | Fitness center (until mid-Dec., 2024) |
| 10 - Avera 69th Street Pharmacy - Behavioral | ||||
| 4400 W 69th St Suite 300 | Sioux Falls | SD | 57108 | Retail pharmacy |
| 11 - Avera McKennan Hosp & Univ Campus Pharm | ||||
| 1325 S Cliff Avenue | Sioux Falls | SD | 57105 | Retail pharmacy |
| 12 - Avera Institute for Human Genetics | ||||
| 1301 S Cliff Avenue | Sioux Falls | SD | 57108 | Genetic research program |
| 13 - Laurel Oaks Apartments | ||||
| 4510 S Prince of Peace Place | Sioux Falls | SD | 57103 | Independent living apartments |
| 14 - Avera Medical Group Sibley | ||||
| 600-9th Avenue North | Sibley | IA | 51249 | Primary care clinic |
| 15 - Avera Research Institute | ||||
| 6001 S Sharon Ave | Sioux Falls | SD | 57108 | Clinical research studies |
| 16 - Avera Dermatology Pharmacy | ||||
| 6701 South Minnesota Avenue | Sioux Falls | SD | 57108 | Retail pharmacy |
| 17 - Avera Medical Group Occupational Med | ||||
| 2100 S Marion Rd | Sioux Falls | SD | 57106 | Business and corporate health care clinic |
| 18 - Avera Medical Group Big Stone City | ||||
| 451 Main Street | Big Stone City | SD | 57216 | Primary care clinic |
| 19 - Hegg Medical Clinic Avera | ||||
| 2121 Hegg Drive | Rock Valley | IA | 51247 | Primary care clinic |
| 20 - Health Care Clinic | ||||
| 300 North Dakota Avenue Suite 117 | Sioux Falls | SD | 57104 | Free healthcare clinic |
| 21 - Community Blood Bank | ||||
| 1301 South Cliff Avenue Suite 3 | Sioux Falls | SD | 57105 | Community blood services |
| 22 - Yorkshire Eye Clinic | ||||
| 2311 Yorkshire Drive | Brookings | SD | 57006 | Ophthalmology and optometry clinic |
| 23 - Rural Medical Clinics | ||||
| 301 South Walnut Street | Freeman | SD | 57029 | Primary care clinic |
| 24 - Dakota Family Medical Center | ||||
| 101 South Front PO Box 27 | Chamberlain | SD | 57325 | Primary care clinic |
| 25 - Pipestone Medical Group Avera | ||||
| 920 - 4th Avenue SW | Pipestone | MN | 56164 | Primary care clinic |
| 26 - Avera Medical Group McGreevy Salem | ||||
| 740 South Hill | Salem | SD | 57058 | Primary care clinic |
| 27 - Avera Medical Group Larchwood | ||||
| 916 Holder Street PO Box 8 | Larchwood | IA | 51241 | Primary care clinic |
| 28 - Avera Medical Group Lakefield | ||||
| 221 3rd Avenue | Lakefield | MN | 56150 | Satellite primary care clinic |
| 29 - Avera Addiction Care Center | ||||
| 6140 S Curae Lane | Sioux Falls | SD | 57108 | Addiction care facility |
| 30 - Avera Human Performance | ||||
| 6800 S Louise Avenue | Sioux Falls | SD | 57108 | Sports medicine and training facility |
| 31 - AMG-McGreevy Dawley Farm Urgent Care | ||||
| 1600 South Highline Place | Sioux Falls | SD | 571101000 | Urgent care |
| 32 - AMG-McGreevy Family Hlth Ctr Urgent Care | ||||
| 2100 S Marion Rd | Sioux Falls | SD | 571063646 | Urgent care |
| 33 - Avera on Louise Health Campus | ||||
| 6100 S Louise Ave | Sioux Falls | SD | 57108 | Inpatient & Outpatient Surgical Hospital |
| 34 - Avera Pharmacy - SF Louise Avenue | ||||
| 6100 S Louise Ave | Sioux Falls | SD | 57108 | Retail pharmacy |
| 35 - Avera Medical Group Dermatology Aberdeen | ||||
| 105 S State Street Suite 202 | Aberdeen | SD | 57401 | Dermatology clinic |
| 36 - Avera Medical Group Dermatology Brooking | ||||
| 310 22nd Ave | Brookings | SD | 57006 | Dermatology clinic |
| 37 - Avera Medical Group Palliative Medicine | ||||
| 911 E 20th Street Suite 400 | Sioux Falls | SD | 57105 | Palliative Care Clinic |
| 38 - Avera Medical Group Oncology Aberdeen | ||||
| 310 S Penn St | Aberdeen | SD | 57401 | Oncology clinic |
| 39 - Avera Medical Group Oncology Mitchell | ||||
| 605 N Foster St | Mitchell | SD | 57301 | Oncology clinic |
| 40 - Avera Medical Group Oncology Yankton | ||||
| 501 Summit Street Suite 400 | Yankton | SD | 57078 | Oncology clinic |
| 41 - Avera Dialysis | ||||
| 4210 West 53rd Street | Sioux Falls | SD | 57106 | Dialysis |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | The methodology used to determine eligibility for financial assistance takes into consideration income, net assets, family size and resources available to pay for care. In addition, presumptive charity care may be applied in situations where all other avenues have been exhausted. |
| Part I, Line 6a: | The community benefit report is prepared by a related organization, Avera Health, and is available to the public at https://www.avera.org/about/annual-report/. |
| Part I, Line 7: | A combination of costing methodology was used to calculate the amounts reported in the table. A cost accounting system was used to calculate Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for our tertiary medical center. A cost to charge ratio derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to calculate charity care at cost for all entities and Medicaid and Means-tested Government Program expenses and shortfalls and Subsidized Health Services for any operations outside of the tertiary medical center. For all other amounts, costs and revenues as reflected by the general ledger system were used. |
| Part I, Line 7g: | Physician clinic costs for transplant services and behavioral health services are included in subsidized health services. Revenue of $10,373,264 and costs of $20,110,393 were included for a net community benefit of $9,737,129. Our facility is the principal provider of bone marrow, pancreas and kidney transplant services throughout our service area, with the clinics as a crucial component of successful pre- and post-transplant care. Similarly, our behavioral health clinics are key supports to patients whether as primary care for behavioral health needs or support in conjunction with inpatient treatment. |
| Part II, Community Building Activities: | The community building activities include monetary assistance to organizations that focus their efforts on providing neighborhood improvement projects in high needs areas, children and youth development programs, local economic development, and job creation and training programs. |
| Part III, Line 2: | The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concessions based on its historical collection experience with the respective class of patients and residents. |
| Part III, Line 4: | The footnote to the Organization's financial statements that describes implicit price concession is located in the audited financial statement report on pages 18 and 19. |
| Part III, Line 8: | The Medicare revenues received (line 5), allowable costs (line 6), and the resulting loss (line 7) does not include a significant portion of the Organization's expenses. These lines require use of the Medicare cost report as prepared by the required guidelines which disallows numerous costs of hospitals, particularly if they are part of an integrated system such as Avera McKennan. In these cases, the entity must file a home office cost report which "steps down" overhead to non-cost report entities disproportionately to actual allowable share and essentially removes the costs from the hospital's cost report entirely. Examples of a portion of these overhead costs would be finance, business office, information technology, human resources, and administration. Examples of non-cost report entities operated by Avera McKennan include clinics, mobile imaging services, long-term care facilities, and other health care related businesses. There are also costs completely disallowed by cost report rules such as bad debt expense, hospitalists care, CRNA's, and interest expense. Avera McKennan also receives a Medicare Disproportionate Share Hospital (DSH) adjustment as part of the cost report due to its significant number of low-income patients served. Part III, line 5 requires inclusion of this revenue though expenses included are much lower. Schedule H instructions also require the exclusion of $13,146,414 of Medicare losses because they are included in Schedule H, Part 1, Line 7f or 7g. Including the Medicare percentage of disallowed costs, entities which don't file a cost report but nevertheless care for Medicare patients, and the impact of the home office cost report, the Medicare shortfall is $192,880,985 as opposed to a shortfall of $24,874,253. |
| Part III, Line 9b: | If the patient qualifies for the organization's financial assistance policy for low-income, uninsured patients and is cooperating with the organization with regard to efforts to settle an outstanding bill within current self-pay collection policy guidelines and timeframes, the organization or its agent shall not send, nor intimate that it will send, the unpaid bill to any outside collection agency. Avera organizations will allow all individuals 120 days from the first post discharge statement to apply for financial assistance before sending the uncollected account to an outside collection agency. Avera will provide the patient with a statement or final notice that contains a listing of the specific collection action(s) it intends to initiate, and a deadline after which they may be initiated no earlier than 30 days before action is initiated. If the patient qualifies for 100% charity care, no further bills will be sent. A letter will be sent instead indicating that the patient's bill has been completely forgiven. |
| Part VI, Line 2: | Community needs assessment occurs at various points in the system. Through annual strategic planning sessions, community leaders are brought in to update and educate Avera McKennan board members and administrative council on the successes, challenges, and service gaps in the community. Examples include community health workers, community health program leaders, community non-profit leaders, school district officials, state health department officials, and community health organizations. Leaders also serve on boards of various community organizations which seek to address the health and well-being of community members. Local governing boards of outlying facilities, who are members of the community, discuss and help direct resources to areas of targeted needs as well. |
| Part VI, Line 3: | Uninsured patients who hold an inpatient status are counseled by a Patient Advocate to screen them for coverage eligibility and to assist in payer source enrollment. Those that are not eligible are provided a charity care application along with instructions on how to fill out the application. All patients receive statements that indicate who to contact should they need financial assistance. In addition, all patients receive a summary of financial assistance upon registration, as well as in their final statement. Should a patient contact Patient Financial Services and indicate inability to pay, they are transferred to a financial counselor to assist them with the financial assistance application process. Also, inpatient and same day surgery patients receive a brochure in their admissions packet. Pre-collection letters also include information regarding the financial assistance and uninsured programs. |
| Part VI, Line 4: | Avera McKennan's service area is a largely rural population. Services are provided through a health care network of clinics, critical access hospitals and tertiary facilities covering communities in four states. The main tertiary facility is in a population center of over 209,300 served by another non-profit hospital of similar size, Veterans Administration Hospital, a hospital dedicated to diagnosis and treatment of heart disease, and a hospital for children with special health care needs. Outside of this population center, most of the communities served have less than 4,000 residents. The primary service area includes four counties covering approximately 2,600 square miles and contains seven federally designated medically underserved communities. Per the 2024 U.S. Census Bureau QuickFacts data, an average of 7.28% of residents in the primary service area are at or below the poverty level. Our secondary service area covers an additional 17 counties in South Dakota, Iowa, and Minnesota. |
| Part VI, Line 5: | Surplus funds are reinvested in facilities to improve patient care.Medical staff privileges are extended to all qualified physicians in the community. The Avera McKennan Board of Trustees is principally comprised of community members from the primary service area. Members come from a variety of backgrounds ranging from private industry and banking to healthcare.Avera McKennan is a verified Level II trauma center and was the first such Center in the State of South Dakota. Avera McKennan's Emergency Department is staffed 24 hours a day with board-certified emergency specialists and provides emergency care regardless of ability to pay. Avera McKennan had 47,894 Emergency Department visits in FY 2025. Operating both Fixed Wing and Helicopter medical air transports, Avera McKennan's flight teams cover a large geographic area providing state-of-the-art air transport services and access to critical care, with 3,240 flights in the past year.Health Care Clinic: In 1992, Avera McKennan established a Health Care Clinic to provide free care for people who are uninsured or underinsured in the community. The clinic is managed by a Registered Nurse and staffed by Registered Nurses, two midlevel providers, medical residents, and volunteer health care providers. The goal of the clinic is to prevent or treat patients' medical conditions before they become catastrophic. The clinic averages 501 visits per month. The clinic provides preventative care, diagnosis and treatment of illnesses and injuries, medication assistance and assistance in obtaining specialist care for patients with complex cases. The clinic also serves to train physicians, nurses, and other health care students. It provides a free evening clinic one evening per month, staffed by medical students under supervision of physicians. Avera McKennan is the only health care organization to provide free services such as this in the state of South Dakota. The clinic had 6,019 visits in FY 2025. Avera continues to invest in the Community Health Worker program through the Avera Community Health Resource Center. There are a total of 8 Community Outreach Consultants, who are also CHWs, speak a total of 16 languages and work with underserved populations to connect them to resources, navigate healthcare, and provide education. In addition to serving the immigrant and refugee community, a Community Outreach Consultant recently joined the team to serve the Native American population, as well as the justice impacted population. The Avera Community Health Resource Center collaborates with community organizations to provide needed services and education.Residency/Health Professions Training and Internships: In calendar year 2025, Avera McKennan had 128 medical residents in training at Avera McKennan in Internal Medicine, Family Practice, Psychiatry, Geriatrics and Transitional Residency Programs offered in partnership with the University of South Dakota School of Medicine. Over 1,000 students in medicine, nursing, pharmacy, physician assistant programs, medical assisting, radiology, and respiratory therapy also completed clinical rotations at Avera McKennan. In non-clinical areas, Avera McKennan offers paid and nonpaid internships in the areas of research, finance, administration, therapies, exercise science and social work. Avera McKennan is currently legally affiliated with 267 institutions of higher education.Patient and Community Education: Avera McKennan is a regional leader in offering educational programs for a variety of learners, leaders, and employees. Utilizing advanced technology, many of these programs are provided electronically throughout the tri-state area. Educational sessions are offered to medical staff, employees, health care professionals, students at all levels, and the general public. Utilizing Avera McKennan's Education Center, a broad cross-section of classes involving diverse audiences are provided as a community service each year. 1. Online resources: Avera McKennan offers vast free patient educational online resources on its public website on numerous health topics, with suggestions for lifestyle change, behavior modification and management for improved health. 2. To Be Well free education events were held on topics including orthopedics, cancer, diabetes, weight loss/healthy eating, multiple sclerosis, anxiety, and acupuncture. 3. Forums: The Avera Behavioral Health Center offers free Friday Forums, in which school counselors and therapists are invited to presentations on children's mental health topics such as conflict cycles, reactive attachment disorder, depression and bipolar disorder in children, and teen substance use, abuse and addiction. 4. The Avera Behavioral Health Center offers free monthly educational sessions on various topics followed by discussion for adults who have been impacted by a loved one's mental illness. Topics have included grief and loss, anxiety, and parenting strategies for managing challenging behaviors. 5. Women's & Children's Services: Avera McKennan's Women's & Children's Services offers a number of parenting and community education opportunities for free or at a minimal cost. In fiscal year 2025, 56 childbirth education classes were held with 934 attendees, as well as 96 participants online. 6. Daycare training: Free of charge, Avera McKennan offers two in-service training sessions per month to daycare providers through EmBe, with a total of 12 scheduled annually, and additional sessions for requested topics. Support groups: Avera McKennan offers approximately 10 free support groups. They range in topic from cancer to liver disease, diabetes, bone marrow transplant, stroke, and grief and loss. The organization provides free meeting space as well as speakers and leaders. Information and Assistance: Avera McKennan operates a 24-hour Medical Call Center, through which patients have access to nurse triage at no cost to the patient. Patients can call a toll-free number and talk personally with a Registered Nurse to ask health questions or receive general health information. Avera McKennan's web site also provides an extensive health library that consumers can access free of charge.Interpreter service: Avera McKennan employs two full-time, one part-time and two PRN Spanish interpreters in-house, and also employs Community Outreach Consultants that can serve as interpreters for Arabic, Amharic, Oromo, Russian and Kunama. Their services are offered to patients free of charge. In addition, in cooperation with external agencies, Avera McKennan is able to handle 240 different languages and dialects through phone, video remote interpreting and other means. Interpretation services are available for patients when they are at Avera McKennan in person, or when they call by phone. All the above services are provided at no cost to the patient.Transport to Transplant: Avera McKennan developed the Transport to Transplant project, which removes transportation barriers for patients from rural areas which may prevent them from completing the evaluation and testing needed for kidney and/or pancreas transplant. A van funded through a grant from the Avera McKennan Foundation is used to transport patients who demonstrate a financial need. Patients are brought to the Avera Transplant Institute for a condensed multi-day evaluation with all testing and visits completed in less than one week. Ultimately, the project results in improved morbidity and mortality, as kidney transplant doubles patient survival as compared to remaining on dialysis.Avera Family Wellness: This program is designed to support families and children in need of early intervention mental health services. The families have direct access to mental health services when needed. This program combines positive activities like mental health therapy (our therapists are specifically trained in dealing with high need families, a variety of play therapies and addressing issues of childhood trauma), psychiatry, family and school coordination and classroom enrichment services. Referrals come from the early childhood program, as well as our partner elementary schools. The goal is to lessen the number of adverse childhood experiences to improve the chances for children living in poverty to be successful in school and in life. Families with the most difficult situations are being referred by the school district. We expanded our number of counselors for this program as the need has grown.Continued below. |
| Part VI, Line 6: | Avera is a sponsored ministry of the Benedictine and Presentation Sisters. The communities in which Avera operates all have unique health and community benefit needs. In keeping with the Catholic Healthcare Association guidelines, each hospital strives to meet its community's identified needs. The corporate staff of Avera Health advocates for all members regarding community benefit related matters of state, regional and national importance. |
| Part VI, Line 5, continued: | The Walsh Family Village: This hospitality house complex adjacent to the Avera McKennan campus provides a home away from home for patients and their families who come for care at Avera McKennan from outside of Sioux Falls. The project was funded by donations and is operated by Avera McKennan. 25 guest rooms are available. Avera McKennan also donates use of the building in the complex for a Ronald McDonald House for families of pediatric patients. If they can afford it, guests are charged a low fee per night. Guests are not turned away due to inability to pay the fee. Employees regularly donate non-perishable food items to stock a food pantry for guests. In fiscal year 2025, the Walsh Family Village served 1,011 guests, staying in 6,916 nightly rooms, a 83% occupancy. Avera McKennan provides a subsidy of approximately $439,000 per year to operate the hospitality complex. Prevention and support of substance use disorder: Avera McKennan is a partner with Face it TOGETHER, Inc., a nonprofit organization which serves as the local face and voice of recovery from addiction through its recovery support services, advocacy and awareness programs. Avera has been a partner with Face it TOGETHER since its inception, and in a recent awareness campaign.Support of the arts and cultural life: Avera McKennan hosts Sioux Falls' only indoor SculptureWalk. Artists donate sculptures for one year, which are placed at locations throughout Avera McKennan's campus, in buildings connected by skywalks. Brochures contain a map, and visitors who follow the route suggested walk approximately 1 mile, making this a healthy as well as a cultural journey.Community Benefits: Avera McKennan provides additional community benefits including: support of youth programs; homeless programs; community arts programming; health promotion; awareness and education about cancer, heart disease and other conditions; and support of the Sioux Empire United Way and other services in the region. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Dakota Department of Health | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 East Capitol Ave | AddressLine1Txt |
| City | Pierre | CityNm |
| State Abbreviation | SD | StateAbbreviationCd |
| ZIP | 57501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 466000364 | RecipientEIN |
| IRC Section | Gov | IRCSectionDesc |
| Cash Grant | $15,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | Women's Cancer Network | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | Assistance with medical expenses | GrantTypeTxt |
| Recipient | 3969 | RecipientCnt |
| Cash Grant | $601,183 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | The governing board and management develop programs which enhance the charitable mission of the Organization. Disbursement for grants or assistance for these programs are made in accordance with prescribed procedures and are subject to conditions established by the Organization's governing board and management, which are designed to ensure that individuals and organizations receiving grants or assistance are adequately investigated to ensure that they are qualified recipients. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Geoffrey Haft MD | ||||||||||||||
| Orthopedics/Surgery | $1,687,519 | $0 | $16,000 | $0 | $84,626 | $0 | $17,250 | $0 | $42,414 | $0 | $1,847,809 | $0 | $0 | $0 |
| Todd Zimprich MD | ||||||||||||||
| Neurology | $1,489,391 | $0 | $183,340 | $0 | $15,461 | $0 | $17,250 | $0 | $37,658 | $0 | $1,743,100 | $0 | $0 | $0 |
| Jonathan Gilhooly MD | ||||||||||||||
| Neurosurgery | $1,559,036 | $0 | $15,400 | $0 | $94,336 | $0 | $17,250 | $0 | $38,207 | $0 | $1,724,229 | $0 | $0 | $0 |
| Alex Linn MD | ||||||||||||||
| Neurology | $1,496,031 | $0 | $36,000 | $0 | $2,278 | $0 | $17,250 | $0 | $35,158 | $0 | $1,586,717 | $0 | $0 | $0 |
| Richard J Conklin MD | ||||||||||||||
| Oncology | $1,444,423 | $0 | $36,600 | $0 | $29,021 | $0 | $17,250 | $0 | $43,184 | $0 | $1,570,478 | $0 | $0 | $0 |
| David Flicek | ||||||||||||||
| Former President & CEO | $0 | $1,382,300 | $0 | $47,730 | $0 | $20,110 | $0 | $17,250 | $0 | $29,812 | $0 | $1,497,202 | $0 | $0 |
| Julie Lautt CFO Avera | ||||||||||||||
| Health;Secretary/Treasurer | $0 | $1,226,098 | $0 | $41,964 | $0 | $6,301 | $0 | $17,250 | $0 | $2,968 | $0 | $1,294,581 | $0 | $0 |
| Ronald Place MD | ||||||||||||||
| President & CEO | $0 | $1,045,760 | $0 | $35,190 | $0 | $13,020 | $0 | $17,250 | $0 | $11,667 | $0 | $1,122,887 | $0 | $0 |
| Cristina Hill Jensen MD | ||||||||||||||
| Board Member/Gastroenterology | $812,824 | $0 | $155,541 | $0 | $3,344 | $0 | $17,250 | $0 | $41,044 | $0 | $1,030,003 | $0 | $0 | $0 |
| Benjamin Solomon MD | ||||||||||||||
| Board Member/Oncology & Hematology | $659,315 | $0 | $126,457 | $0 | $1,585 | $0 | $17,250 | $0 | $45,614 | $0 | $850,221 | $0 | $0 | $0 |
| Jawad Nazir MD Board Member | ||||||||||||||
| Infectious Disease & Internal Med | $598,888 | $0 | $34,952 | $0 | $4,965 | $0 | $17,250 | $0 | $46,614 | $0 | $702,669 | $0 | $0 | $0 |
| Brenda Kallemeyn MD Board Member | ||||||||||||||
| /Chief of Staff/ OB & Gyn | $433,676 | $0 | $31,223 | $0 | $1,252 | $0 | $17,250 | $0 | $16,186 | $0 | $499,587 | $0 | $0 | $0 |
| Tamera Larsen Engelkes | ||||||||||||||
| Chief Nursing Officer | $326,986 | $0 | $700 | $0 | $774 | $0 | $16,420 | $0 | $2,384 | $0 | $347,264 | $0 | $0 | $0 |
| Alisa Reindl MD | ||||||||||||||
| Board Member/Family Med, OB | $213,349 | $0 | $16,265 | $0 | $739 | $0 | $11,664 | $0 | $13,694 | $0 | $255,711 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3: | FormAndLineReferenceDesc |
| Explanation | The President and CEO is compensated by Avera Health. Avera McKennan relied on the related organization for determining the compensation for the President using the methods described in Part I, Line 3. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kelsey Knecht | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Family of Board Member | RelationshipDescriptionTxt |
| Transaction | $92,714 | TransactionAmt |
| Transaction | Employee Compensation | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | David Flicek, Ronald Place, Julie Lautt, Sister Candyce Chrystal, Sister Lucille Welbig, and Sister Roxanne Seifert have a business relationship. |
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is Avera Health, a nonprofit corporation organized and existing under the laws of the state of South Dakota and exempt under section 501(c)(3) of the Internal Revenue Code of 1986, as amended. |
| Form 990, Part VI, Section A, line 7a | Avera Health, as the sole member, has the power to appoint and remove, with or without cause, all members of the board of directors. |
| Form 990, Part VI, Section A, line 7b | Avera Health, as the sole member, has the following rights as the Member: 1) To approve the adoption, amendment or repeal of the statements of philosophy, mission and values of Corporation; 2) To initiate the adoption, amendment or repeal of any provision of the Articles of Incorporation or Bylaws of Corporation, and to give final approval of any such action with respect thereto; 3) To approve and act upon the alienation of real property and precious artifacts under the canonical stewardship of the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen, South Dakota ("Presentation Sisters") or the Benedictine Sisters of Sacred Heart Monastery ("Benedictine Sisters"), pursuant to the policies established by the Member; 4) To approve any plan of merger, consolidation or dissolution of the Corporation, or the divestiture of a sponsored work or ministry associated with the Corporation; 5) To approve the creation of new sponsored works or ministries to be conducted by or under the authority of the Corporation; 6) To appoint and remove, with or without cause, the Board of Directors of the Corporation. 7) To appoint and/or remove, with or without cause, the President and Chief Executive Officer of the Corporation. 8) To approve operating/capital budgets and strategic plans of the Corporation. 9) To approve expenditures outside of operating and capital budgets exceeding defined thresholds according to policy which may be adopted from time to time by the Member. 10) To approve acquisitions, sales and leases, according to policy which may be adopted from time to time by the Member. 11) To establish and maintain employee benefit programs. 12) To establish and maintain insurance programs. 13) To approve major community fund drives. 14) To approve the appointment of auditors. 15) To adopt policies designed to effectuate the reserved powers of the Member. 16) To initiate and give final approval to equity and asset transfers by and between the Member and the Corporation and any affiliates or subsidiaries of the Member. 17) To initiate and give final approval to (i) any and all issuances of obligations under any existing or future master indentures binding the Corporation, any indebtedness (including, without limitation, capitalized leases) in excess of dollar thresholds as may be from time to time established by the Member, and (ii) any pledges of collateral for such indebtedness and any pledges of real estate as collateral for any indebtedness regardless of amount. 18) Full and exclusive power to execute supplemental master indentures, including, without limitation, those authorizing the issuance of obligations or series of obligations, (ii) full and exclusive power to prepare, or authorize the preparation of, any and all documents, agreements, swap agreements, investment contracts, certificates and disclosure materials (including, without limitation, Official Statements and any supplements thereto) reasonably and ordinarily prepared in connection with the issuance of obligations thereunder, or related bonds associated therewith and to execute and deliver such items to the appropriate parties in connection therewith and (iii) full and exclusive power to authorize the entrance of members to, or withdrawal of members from, any obligated group, subject to the other requirements of the applicable master indenture for such entrance or withdrawal. |
| Form 990, Part VI, Section A, line 8b | Avera McKennan does not have any committees with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is prepared and reviewed by an independent accounting firm. The Form 990 is then reviewed by the Avera Health VP of Financial Reporting and Tax Manager. After initial internal review, the Form 990 is made available to various members of Avera Health Executive Management, including the Avera Health CFO, President/CEO and COO. In addition, the Form 990 is made available to the Facility CEO, other Operation Finance Leaders and the Facility Board members. |
| Form 990, Part VI, Section B, line 12c | The Conflict of Interest Policy covers Board members, officers, and key employees. At each board meeting, a request is made for all Board members to disclose any potential conflict of interest pertaining to any item listed on the agenda or pertaining to any potential item that could be discussed during the course of the meeting. The Declaration of Conflict of Interest is recorded in the meeting minutes. The Board makes a determination of whether there is a conflict of interest and if so, implements the procedure for evaluating the issue or transaction involved. The board member or officer with the conflict must refrain from voting. A statement of conflict of interest disclosure is made on an annual basis by officers and directors. The information is maintained in a database and a report is provided to the Board. |
| Form 990, Part VI, Section B, line 15b | The CEO and CFO-Avera Health are compensated by Avera Health. Annually the Compensation Committee of Avera Health, which is comprised of the Caring for Life Catholic Health Ministries Members of Avera Health, meets with an independent consultant regarding fair market value of officers and key employees. The Compensation Committee approves all salaries based on comparable data and documents the basis for their decision in meeting minutes. Depending on the individual's role with the organization, some officers and key employees are compensated by Avera McKennan. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents and conflict of interest policy are not made available to the general public. The Organization's financial statements are attached to the Form 990 per IRS instructions and therefore available to the general public. |
| Form 990, Part VI, Section B, Line 16b: | There is no written policy or procedure requiring the Organization to evaluate its participation in joint venture arrangements. In the event of any such proposed transaction the board, or a committee with delegated authority, reviews all materials, valuations, and operational aspects for any proposed transaction. Such transaction would be evaluated in accordance with the exempt status of the Organization and its applicable purposes. Any transaction also must be approved by the board and the member. |
| Form 990, Part IX, line 11g | Purchased Services: Program service expenses 94,683,196. Management and general expenses 3,011,030. Fundraising expenses 56,238. Total expenses 97,750,464. Medical Professional Fees: Program service expenses 25,565,137. Management and general expenses 30,164. Fundraising expenses 0. Total expenses 25,595,301. Repairs & Maintenance: Program service expenses 32,422,990. Management and general expenses 726,704. Fundraising expenses 0. Total expenses 33,149,694. Centralized Services: Program service expenses 60,737,548. Management and general expenses 103,838,338. Fundraising expenses 0. Total expenses 164,575,886. |
| Form 990, Part X, Line 20: | The issue price includes the filing Organization's share of the entire bond issue, which was issued to Avera Health on behalf of the Avera Obligated Group. The Avera Obligated Group consists of Avera Health, Avera McKennan, Avera St. Luke's, Avera Queen of Peace, Avera Sacred Heart, Avera Marshall, Avera St. Mary's, Avera St. Anthony's, Avera St. Benedict, Avera Holy Family, Avera Tyler, Avera Granite Falls, Avera Gettysburg, and Avera at Home. In accordance with IRS instructions, information related to the tax exempt bond reporting is being reported on Avera Health's tax return (EIN 46-0422673.) |
| Form 990, Part XI, line 9: | Change in Assets with Donor Restrictions 6,631,541. Other changes in net assets 2,602,538. Change in Interest of Avera Health Foundation 2,942,223. |
| Form 990, Part XII, Line 2c: | The Audit Committee of Avera Health, parent organization of Avera McKennan, selects the auditor and reviews the consolidated audited financial statements for Avera Health, which includes Avera McKennan. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| Alumend LLC | |||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 571175045 | 460224743 | Research and development | SD | -$106,053 | $0 | Avera McKennan |
| MRIS LLC | |||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 571175045 | 470874983 | Healthcare Services | SD | $0 | $0 | Avera McKennan |
| Sioux Falls Hospital Management LLC | |||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 571175045 | 562141521 | Management company of Heart Hospital | SD | $4,599,778 | $12,356,067 | West 69th Street LLC |
| West 69th Street LLC | |||||||||
| 1325 S Cliff Ave PO Box 5045 | Sioux Falls | SD | 571175045 | 460224743 | Holding company | SD | $4,599,778 | $12,356,067 | Avera McKennan |
| Dakota Vantage LLC | |||||||||
| 3900 W Avera Drive | Sioux Falls | SD | 57108 | 392541215 | Accountable Care Organization | SD | $0 | $0 | Avera McKennan |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Health | |||||||||||
| 3900 West Avera Drive Suite 300 | Sioux Falls | SD | 57108 | 460422673 | Promotion of Health | SD | 501(c)(3) | Line 10 | N/A | 0 | |
| Avera at Home | |||||||||||
| 5300 S Broadband Lane | Sioux Falls | SD | 57108 | 460399291 | Home Services | SD | 501(c)(3) | Line 10 | 0 | Avera Health | |
| Avera Health Plans Inc | |||||||||||
| 3900 West Avera Drive Suite 101 | Sioux Falls | SD | 57108 | 460451539 | Health Financing and Health Plan Admin | SD | 501(c)(4) | 0 | Avera Health | ||
| Avera Marshall | |||||||||||
| 300 S Bruce Street | Marshall | MN | 56258 | 410919153 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Granite Falls | |||||||||||
| 345 10th Ave | Granite Falls | MN | 56241 | 843156881 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
| Avera Tyler | |||||||||||
| 240 Willow Street | Tyler | MN | 56178 | 410853163 | Healthcare Services | MN | 501(c)(3) | Line 3 | 0 | Avera Marshall | |
| Avera Queen of Peace Hospital | |||||||||||
| 525 North Foster Street | Mitchell | SD | 57301 | 460224604 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera St Anthony's Hospital | |||||||||||
| 300 N 2nd Street | ONeill | NE | 68763 | 470463911 | Healthcare Services | NE | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera St Luke's | |||||||||||
| 305 South State Street | Aberdeen | SD | 57401 | 460224598 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera St Mary's | |||||||||||
| 801 East Sioux Avenue | Pierre | SD | 57501 | 460230199 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Avera Gettysburg | |||||||||||
| 606 East Garfield | Gettysburg | SD | 57442 | 460234354 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera St Mary's | |
| Avera Holy Family | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 420680370 | Healthcare Services | IA | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Holy Family Hospital Foundation | |||||||||||
| 826 North 8th Street | Estherville | IA | 51334 | 421317452 | Support Health Related Services | IA | 501(c)(3) | Line 10 | 0 | Avera Holy Family | |
| Sacred Heart Health Services | |||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460225483 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
| Lewis and Clark Health Education and Service Agency | |||||||||||
| 1000 W 4th Street Suite 9 | Yankton | SD | 57078 | 460337013 | Healthcare Services | SD | 501(c)(3) | Line 10 | 0 | Avera Health | |
| St Benedict Health Center | |||||||||||
| 401 West Glynn Drive | Parkston | SD | 57366 | 460226738 | Healthcare Services | SD | 501(c)(3) | Line 3 | 0 | Avera Health | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Avera Home Medical Equipment of Floyd Valley Hospital LLC | ||||||||||||||
| 5300 S Broadband Lane | Sioux Falls | SD | 57108 | 820582350 | Medical Services - Home Medical Equipment | SD | N/A | 0 | 0 | |||||
| Avera Home Medical Equipment of Lakes Regional Healthcare LLC | ||||||||||||||
| 5300 S Broadband Lane | Sioux Falls | SD | 57108 | 862949748 | Medical Services - Home Medical Equipment | SD | N/A | 0 | 0 | |||||
| Avera Home Medical Equipment of Sioux Center LLC | ||||||||||||||
| 5300 S Broadband Lane | Sioux Falls | SD | 57108 | 753203100 | Medical Services - Home Medical Equipment | SD | N/A | 0 | 0 | |||||
| Avera Home Medical Equipment of Spencer Hospital LLC | ||||||||||||||
| 5300 S Broadband Lane | Sioux Falls | SD | 57108 | 800619999 | Medical Services - Home Medical Equipment | SD | N/A | 0 | 0 | |||||
| Brookings Health System - Avera HME LLC | ||||||||||||||
| 100 22nd Ave Suite 101 | Brookings | SD | 57006 | 453204123 | Medical Services - Home Medical Equipment | SD | N/A | 0 | 0 | |||||
| Caravan Health ACO 15 LLC dba Prairie Vista Care Organization | ||||||||||||||
| 20 Burton Hills Blvd Ste 100 | Nashville | TN | 37215 | 611843657 | Accountable Care Organization | MO | N/A | 0 | 0 | |||||
| Caravan Health ACO 41 dba Prairie View Care Organization | ||||||||||||||
| 20 Burton Hills Blvd Ste 100 | Nashville | TN | 37215 | 821447782 | Accountable Care Organization | MO | N/A | 0 | 0 | |||||
| Heart Hospital of South Dakota LLC | ||||||||||||||
| 4500 W 69th Street | Sioux Falls | SD | 57108 | 562143771 | Healthcare Services | NC | 0 | 0 | Avera McKennan | Related | $6,064,071 | $52,941,489 | 0.66670 | |
| Surgical Associates Endoscopy Clinic LLC | ||||||||||||||
| 310 S Pennsylvania St | Aberdeen | SD | 57401 | 460461429 | Surgical Associates | SD | N/A | 0 | 0 | |||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Share Of Total IncomeShareOfTotalIncomeAmt | OwnershipOwnershipPct | Share Of EOY AssetsShareOfEOYAssetsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Accounts Management Inc | ||||||||||||||||||
| 5132 S Cliff Ave Suite 101 | Sioux Falls | SD | 57108 | 460373021 | Collection Agency | SD | N/A | C | 0 | |||||||||
| Alucent Australia Pty Ltd | ||||||||||||||||||
| Biotech Research | Yes (1) | Level 10 30 Collings Street | Melbourne | VIC 3000 | AS | AS | Alucent Biomedical Inc | $569,662 | 0.70200 | |||||||||
| Alucent Biomedical Inc | ||||||||||||||||||
| 1325 S Cliff Avenue PO Box 5045 | Sioux Falls | SD | 571175045 | 471818349 | Biotechnology | SD | C | Yes (1) | Alumend LLC | -$4,930,272 | 0.70200 | $514,825 | ||||||
| Avera Property Insurance Inc | ||||||||||||||||||
| 1000 West 4th Street Suite 1 | Yankton | SD | 57078 | 460463155 | Insurance | SD | N/A | C | 0 | |||||||||
| DakotaCare Administrative Services Inc | ||||||||||||||||||
| 5300 South Broadband Lane | Sioux Falls | SD | 57108 | 460424322 | Insurance | SD | N/A | C | 0 | |||||||||
| South Dakota State Medical Holding Company Inc | ||||||||||||||||||
| 5300 South Broadband Lane | Sioux Falls | SD | 57108 | 460401087 | Insurance | SD | N/A | C | 0 | |||||||||
| Valley Health Services | ||||||||||||||||||
| 501 Summit Street | Yankton | SD | 57078 | 460357149 | Rental Real Estate | SD | N/A | C | 0 | |||||||||
| Kore Cares In Home Services LLC | ||||||||||||||||||
| 5300 South Broadband Lane | Sioux Falls | SD | 57108 | 882778902 | In-Home Care Services | SD | N/A | S | 0 | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Avera Heart Hospital of South Dakota LLC | ||
| L | $3,943,093 | Intercompany detail from GL |
| Avera Heart Hospital of South Dakota LLC | ||
| Q | $4,685,444 | Intercompany detail from GL |
| Avera Heart Hospital of South Dakota LLC | ||
| R | $3,947,912 | Intercompany detail from GL |
| Avera Heart Hospital of South Dakota LLC | ||
| S | $9,469,330 | Intercompany detail from GL |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Schedule R, Part II, Tax Exempt Organizations: | Holy Family Hospital Foundation dissolved November 2024. |
| Form 990, Schedule R, Part IV, Corporation or Trust: | Valley Health Services dissolved June 2025. Alucent Biomedical, Inc. dissolved May 2025. Alucent Australia Pty Ltd dissolved May 2025. Income and Assets reported for Alucent Biomedical, Inc and Alucent Australia Pty Ltd are for the tax year ended 12/31/2024. |